The key takeout’s of the Royal Commission in 2019

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Our Editorial Director Lauren Broomham attended every session and community forum of the Royal Commission last year and every night wrote her detailed report, with her personal perspectives, in our Daily COMMISSION newsletter (Subscribe HERE).

Here are her key takeout’s for 2019.

The Commissioners now understand aged care – and the power of the media

We have seen Commissioners Lynelle Briggs and the late Richard Tracey – and now Tony Pagone – become more engaged in asking questions – and making points – as the year has gone on.

Importantly too, the Commissioners have also shown they understand the power of the media, harnessing strong language in the Interim Report to push the Government for action on the three areas they deemed most urgent: home care, chemical restraints and younger people in residential care.

It worked – the Government is now progressing reforms on all three.

To this end, Commissioners Briggs and Pagone have now personally issued a consultation paper outlining a new model which we know from Commissioner Briggs’ comments at community forums, they believe could be implemented in three to five years.

Everything comes back to governance, leadership and culture:

Even though governance was only the focus of the Hobart hearings, these themes permeated the year – and made it clear that ‘care’ – whether ‘good or bad’ – starts at the top.

Providers and facilities who didn’t show strong governance, leading by example and an investment in their people came out second best – or worse.

Boards and CEOs in the firing line:

It was the year that boards and directors were educated on where their responsibilities lie.

No aged care board could emerge from 12 months of the Royal Commission without an understanding that they must be accountable for the care provided to their residents, clients and their families.

The issue of financial and criminal penalties for senior management emerged during the Darwin hearings and never left – this will be another issue that is guaranteed more airing.

Finances are now looming large:

The message from direct experience witnesses was: why are we paying all this money for ‘care’ when Mum or Dad is not receiving it?

Contrasting this opinion was the idea that people need to contribute more to their care – and that if Australians want to receive ‘quality’ care, then they must pay for it.

Finances will be canvassed in 2020 so anticipate seeing these two opposing arguments come to the fore.

A sector increasingly short on cash and big on crisis:

LASA flagged that 197 providers are on the brink of financial collapse and the Aged Care Financing Authority (ACFA)’s own Chair warned that the sector may be financially unsustainable.

But evidence from the Department of Health has shown that the regulator appears unconcerned about the viability of providers, labelling it an “issue for management.”

A solution is required – and soon.

Aged care on the public’s mind – yet to be leveraged:

Media coverage of the Royal Commission has spurned an array of headlines – mostly negative – that have seen aged care move up in the community consciousness.

The sector has not yet been successful in establishing a real campaign to drive public supported reform.

Staff and management are struggling but there is some optimism for 2020:

Providers and staff shared with The Daily COMMISSION their increasing difficulties in managing poor mental health, attracting staff to a sector in the public spotlight and dealing with experienced staff exiting the sector.

Many rejected Commissioner Lynelle Briggs’ concern that the sector lacks the “energy and excitement” for reform but pointed to the increasing regulations as stymieing both enthusiasm and innovation.

But we have also heard some optimism for the future and the changes to come.

Auditors and regulators being increasingly tough on providers:

Facility managers and CEOs throughout the 2019 hearings have pointed to the Aged Care Quality and Safety Commission (ACQSC) and the Department of Health being increasingly hard on providers in their accreditation audits and quality assessors being “punitive” in their visits.

The year also saw a slew of new regulations introduced, including the new Single Aged Care Quality Standards, the Charter of Aged Care Rights, amendments to the Quality of Aged Care Principles 2014 minimising the use of physical and chemical restraints, adding to their regulatory burden.

The Government is focused on home care, not residential care:

The increasing focus of Government funding has been on home care with 10,000 new packages released in February ahead of the Federal Budget and a further 10,000 in response to the Interim Report.

The number of providers offering home care packages moved past the number of residential care providers for the first time in November.

The new model being put forward by the Commissioners is squarely directed at delivering services and supports into the family home.